Temporal arteritis (patient information)
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Temporal arteritis |
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Temporal arteritis On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Temporal arteritis is inflammation and damage to blood vessels that supply the head area, particularly the large or medium arteries that branch from the neck and supply the temporal area.
If the inflammation affects the arteries in your neck, upper body and arms, it is called giant cell arteritis.
What are the symptoms of temporal arteritis?
- Excessive sweating
- Fever
- General ill feeling
- Jaw pain that comes and goes or occurs when chewing
- Loss of appetite
- Muscle aches
- Pain and stiffness in the neck, upper arms, shoulder, and hips
- Throbbing headache on one side of the head or the back of the head
- Scalp sensitivity, tenderness when touching the scalp
- Vision difficulties
- Blurred vision
- Double vision
- Reduced vision (blindness in one or both eyes)
- Weakness, excessive tiredness
- Weight loss (more than 5% of total body weight)
Other symptoms that may occur with this disease:
- Bleeding gums
- Face pain
- Hearing loss
- Joint stiffness
- Joint pain
- Mouth sores
About 40% of people will have other, nonspecific symptoms such as respiratory complaints (most frequently dry cough) or weakness or pain along many nerve areas. Rarely, paralysis of eye muscles may occur. A persistent fever may be the only symptom.
What causes temporal arteritis?
Temporal, giant cell, and cranial arteritis occur when one or more arteries become inflamed, swollen, and tender.
Temporal arteritis most commonly occurs in the head, especially in the temporal arteries that branch off from a blood vessel in the neck called the carotid artery. However, the condition can affect almost any medium-to-large artery anywhere in the body.
The cause is unknown, but is believed to be partly due to a faulty immune response. The disorder has been associated with severe infections and the use of high doses of antibiotics.
The disorder may develop along with or after polymyalgia rheumatica. Giant cell arteritis is almost always seen in people over age 50, but it may sometimes occur in younger people. It is rare in people of African descent. There is some evidence that it runs in families.
Who is at highest risk?
Patients with followings are at increased risk of temporal arteritis: Age > 50 years Hypertension Thrombocytosis Female
Diagnosis
The doctor will examine your head. Touching the head may show that the scalp is sensitive and has a tender, thick artery on one side. The affected artery may have a weak pulse or no pulse.
Blood tests may include:
- Hemoglobin or hematocrit
- Liver function tests
- Sedimentation rate and C-reactive protein
Blood tests cannot diagnose this condition. A biopsy and examination of tissue from the affected artery confirm the diagnosis in most cases. The biopsy is done on an outpatient basis while you are under local anesthesia.
You may also have other tests, including:
When to seek urgent medical care?
Call your health care provider if you have a persistent throbbing headache and other symptoms of temporal arteritis.
Treatment options
The goal of treatment is to reduce tissue damage that may occur due to lack of blood flow.
Your doctor will likely prescribe corticosteroids taken by mouth. Corticosteroids are often started even before a biopsy confirms the diagnosis. Aspirin may also be recommended.
Most people begin to feel better within a few days after starting treatment. However, you need to take medications for 1 - 2 years. The dose of corticosteroids is slowly reduced.
Taking corticosteroid medications for this long can make bones thinner and increase the chance of a fracture. As a result, the following should be started right away:
- Avoid smoking and excess alcohol intake
- Take extra calcium and vitamin D (based on your health care provider's advice)
- Start walking or other doing weight-bearing exercises
- Monitor the bones using a bone mineral density (BMD) test or DEXA scan
Other medications that suppress the immune system are sometimes needed.
Where to find medical care for temporal arteritis?
Directions to Hospitals Treating Condition
Prevention
There is no known prevention.
What to expect (Outlook/Prognosis)?
Most people make a full recovery, but long-term treatment (for 1 to 2 years or longer) may be needed. The condition may return at a later date.
Possible complications
Possible complications, especially if the condition is not treated properly or promptly, include:
- Damage to other blood vessels in the body
- Development of aneurysms (ballooning of blood vessels) in patients with giant cell arteritis
- Sudden vision loss or eye muscle weakness
- TIA or stroke
Side effects from steroid or immune-suppressing medications may also occur.
Sources
http://www.nlm.nih.gov/medlineplus/ency/article/000448.htm